Patients with HIV-associated nephropathy (HIV-AN) have heavy proteinuria, focal segmental glomerulosclerosis, and once azotemia develops, rapid progression to end-stage renal disease. We found that two patients with progressive renal insufficiency and heavy proteinuria secondary to HIV-AN responded to steroid therapy with improvement in renal function. The purpose of the study is to examine the effect of steroid therapy on renal function and proteinuria in patients with biopsy-proven HIV-AN. This pilot study was completed and was the basis for ACTG 271 which is now in place here and at several other sites.